Abstract
A lack of access to methotrexate levels is common in low- and middle-income countries (LMIC), relevant for 80% of children with cancer worldwide. We evaluated whether high-dose methotrexate (HD-MTX) can be administered safely with extended hydration and leucovorin rescue, with monitoring of serum creatinine and urine pH. The prospective study was conducted at a single centre in Chandigarh, India in 2015. Patients with B-cell acute lymphoblastic leukemia (ALL) or with T-cell ALL or non-Hodgkin lymphoma (T-NHL) were administered 3 and 5 gm/m2 of MTX (24 hr infusion), respectively. Six doses of leucovorin (15 mg/m2 /dose), instead of recommended three (for optimally reduced levels) at standard timing (42 hr from start of HD-MTX) were administered. Hydration (125 ml/m2 /hr) was continued for 72 hr, instead of the recommended 30 hr. Hydration fluid consisted of 0.45% sodium chloride, 5% dextrose, 7.5% sodium bicarbonate (50 mmol/l) and potassium chloride (20 mmol/l). Serum creatinine and urine pH were measured at baseline, 24 and 48 hr. The volume of hydration was increased (200 ml/m2 /hr) for a serum creatinine > 1.25 times the baseline. The study included 100 cycles of HD-MTX in 53 patients: B-ALL 25 patients (51 cycles), T-ALL 16...Continue Reading
References
Jan 1, 1979·Cancer Chemotherapy and Pharmacology·W E EvansW R Crom
May 2, 2003·Cancer Chemotherapy and Pharmacology·T SkärbyP Höglund
May 27, 2004·JAMA : the Journal of the American Medical Association·Scott C HowardFrancisco Pedrosa
Jun 2, 2004·Pediatric Blood & Cancer·Pilar JoannonJuan Tordecilla
Jul 15, 2004·Blood·Ching-Hon PuiUNKNOWN Total Therapy Study XIIIB at St Jude Children's Research Hospital
Aug 19, 2004·Blood·Masayuki TowatariUNKNOWN Japan Adult Leukemia Study Group
Sep 23, 2006·Leukemia·T V Ch SkärbyUNKNOWN Nordic Society of Paediatric Haematology and Oncology (NOPHO)
Jan 25, 2012·Pediatric Blood & Cancer·Gauri KapoorSarfraz Abedin
Jun 13, 2013·Hematology/oncology and Stem Cell Therapy·Mohammed RamzanAnupam Sachdeva
Oct 26, 2013·Cancer Chemotherapy and Pharmacology·Wei-qun XuYong-min Tang
May 6, 2014·Hematology/oncology and Stem Cell Therapy·Hasmukh JainM V Chandrakanth
Jul 18, 2015·TheScientificWorldJournal·Shi-Long YangXiao-Jun Xu
Nov 13, 2015·Pediatric Hematology and Oncology·Priya TiwariSameer Bakhshi
Aug 9, 2016·The Oncologist·Scott C HowardR Donald Harvey
Citations
Jul 28, 2018·Pediatric Blood & Cancer·Alan Davidson, Scott C Howard
Nov 28, 2019·Pediatric Blood & Cancer·Deepak BansalGertjan J L Kaspers
Dec 14, 2019·Acta Biochimica Et Biophysica Sinica·Ning Tian, Wanyun Ma
Nov 28, 2019·Leukemia & Lymphoma·Kalasekhar VijayasekharanGaurav Narula
Mar 21, 2020·Pediatric Blood & Cancer·Richa JainDeepak Bansal
May 14, 2020·Pediatric Blood & Cancer·Sanjeev KheraSuman Kumar Pramanik
Jun 24, 2020·Pediatric Blood & Cancer·Lisa Gennarini, Peter D Cole
Aug 20, 2020·Pediatric Blood & Cancer·Himani DhingraAmita Mahajan
Mar 16, 2019·Science·Catherine G LamKathy Pritchard-Jones
Feb 23, 2020·Indian Journal of Pediatrics·Deepak Bansal
Aug 28, 2020·Gut Microbes·H R WardillW J E Tissing
Jul 11, 2020·Indian Journal of Hematology & Blood Transfusion : an Official Journal of Indian Society of Hematology and Blood Transfusion·Piali MandalManish Goel
Mar 26, 2021·Pediatric Hematology and Oncology·Sidharth TotadriRikki John
May 26, 2021·Cancer·Hoa Thi Kim NguyenHiroto Inaba
Aug 12, 2021·Pediatric Hematology and Oncology·Binitha RajeswariPriyakumari Thankamony
Dec 7, 2021·British Journal of Haematology·Maria Luisa MoletiRobin Foà